Endocrine Abstracts

Background: There is currently no agreed consensus for the optimization and titration of mineralocorticoid (MC) therapy in patients with primary adrenal insufficiency (PAI).Objective: To explore the relationship between serum (sFC) and urine (uFC) fludrocortisone levels and biochemically and clinically important variables, and to assess their utility in guiding and titrating MC replacement.Methods: Multi-centre, observational, cros...

Background: There is currently no agreed consensus for the optimization and titration of mineralocorticoid (MC) therapy in patients with primary adrenal insufficiency (PAI).Objective: To measure serum (sFC) and urine (uFC) fludrocortisone levels and explore their relationship with biochemically and clinically important variables (including treatment compliance) in order to evaluate their usefulness as markers to guide the MC replacement titration.<p ...

The importance of measuring renin or plasma renin activity (PRA) and aldosterone in establishing mineralocorticoid deficiency is not in doubt. Once mineralocorticoid replacement therapy is initiated, guidance suggests that optimization of mineralocorticoid dose should be based upon measurements of blood pressure, renin (or PRA), and electrolytes. The aim of this study was to explore the relationship between renin and clinically important variables to determine whether measurem...

Background: Hypopituitarism is a potential complication of trans-sphenoidal adenomectomy (TSA). Recovery of pituitary function can occur, and reassessment is required to avoid unnecessary hormonal replacement. However, frequency of re-testing is variable across centres. Aim of this study was to determine recovery rates and time to recovery of hypothalamo-pituitary adrenal (HPA) and thyroid axis after TSA.Methods: We performed a single-centre, retrospecti...

Background: To date, there is no consensus as to the gold-standard screening test for diagnosing Cushing’s Syndrome (CS).Objectives: This study aimed to: a) compare the ability of late-night salivary cortisol (LNSC) against overnight dexamethasone suppression test (ONDT) and urinary free cortisol (UFC) as screening test for pathological hypercortisolism (PH); b) test the performance of those tests in diagnosing Cushing’s disease (CD) or mild au...

The dexamethasone suppression test (DST) is a common screening test in Cushing’s syndrome but associated with false positive result in 10-20%. One cause of false positivity is inadequate dexamethasone absorption. An assay to measure serum dexamethasone concentration can be used to validate the accuracy of the DST result.Aims: To audit 1) Use of the dexamethasone assay in DSTs 2) How frequently dexamethasone levels are inadequate 3) ...

Objective: 2–3% of the population of the UK receive glucocorticoid (GC) therapy. Significant adverse effects are not confined to chronic use: recurrent short-course administration is associated with increased morbidity and mortality. Data about the cumulative dose responsible for drawbacks during GC treatment are still lacking. The aim of this study was to test the impact of 7 days of 10 or 15 mg of Prednisolone on metabolism in healthy male volunteers.<p class="abste...

Objective: Currently, 2–3% of the population of the UK and US receive glucocorticoid (GC) therapy. Significant adverse effects are not confined to chronic use; recurrent short-course administration is associated with increased morbidity and mortality. The efficacy of GC therapy is not in doubt but data about the cumulative dose responsible for adverse effects during GC treatment are still lacking. The aim of this study was to test the impact of 7 days of 10 or 15 mg of Pr...

Introduction: With the improved imaging techniques, Leydig cell tumours (LCTs) are frequently found, accounting up to 22% of testicular tumours. The natural history of LCTs is relatively unknown, because of the small size and heterogeneity of available studies. Since LCTs are often removed, long-term follow-up is missing. The aim of this study was to report the experience with a large cohort of prospectively collected LCTs.Materials and methods: Patients...

Background: Patients with adrenal incidentalomas and possible autonomous cortisol secretion (pACS) suffer from a high rate of cardiovascular events and mortality. We have previously showed that left ventricular mass index (LVMi) is higher in patients with pACS, compared with patients with non-functioning adenomas (NFA). To date, the management of pACS is still controversial, with a lack of consensus regarding the benefits of surgery.Objectives: This pros...